Early detection, PSA screening, and management of overdiagnosis

Hematol Oncol Clin North Am. 2013 Dec;27(6):1091-110, vii. doi: 10.1016/j.hoc.2013.08.002. Epub 2013 Sep 18.

Abstract

Prostate cancer diagnosis and treatment rates have increased significantly since the introduction of prostate-specific antigen (PSA) screening. Although it was initially thought that most prostate cancers would lead to death or significant morbidity, recent randomized trials have demonstrated that many patients with screening-detected cancer will not die of their disease. Modifications to PSA screening, screening guideline statements, and novel screening markers have been developed to minimize the risk and morbidity associated with overdiagnosis and overtreatment. Less aggressive management strategies such as active surveillance may lead to lower treatment rates in men who are unlikely to benefit while maintaining cure rates.

Keywords: Active surveillance; Early detection; Overdiagnosis; PSA screening; Prostate cancer.

Publication types

  • Review

MeSH terms

  • Early Detection of Cancer* / methods
  • Humans
  • Male
  • Practice Guidelines as Topic
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / diagnosis*
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Prostate-Specific Antigen